The goals of the University of Iowa as members of the Cancer and Leukemia Group B over the next five years are: 1) to sustain our pattern of increasing accrual to CALGB trials; 2) to continue to develop programs in both clinical and basic science areas at the University of Iowa which will lead to innovative clinical trials for the group; and 3) to add further affiliates in rural areas in Iowa so that state-of-the-art cancer care can be brought to these communities too small to support cancer programs. Over the last four years of the grant, our accrual went from 98/year to 148/year. Our stated goal in the last grant was to accrue approximately 100+ patients per year. In the first three months of 1992 we have accrued 52 patients (a rate of 208/yr). We hope to average 175 pts/year in this grant period. Current or soon to be open CALGB trials initiated from the University of Iowa include: 1) subcutaneous IL-2 in advanced small cell lung cancer with assay at the University of Iowa of sIL-2 receptor and LAK cell generation; and 2) the use of stem cells to allow multiple cycles of intensive chemotherapy without autologous bone marrow transplant. Basic science programs with potential for future CALGB trials are: 1) the development of bispecific monoclonal antibodies to lymphoma cell antigens; 2) studies in vitro of HMG-CoA reductase inhibitors to block the farnesylation and geranylation necessary for RAS expression; and 3) the use of PCNA as an intermediate marker for the development of neoplasia in the lung. Medical oncologists from the University of Iowa are now serving Mount Pleasant, Iowa and Muscatine, Iowa. Affiliates are going in Mason City, Davenport, and Waterloo. We are exploring further outreach programs in towns too small to ever support a fulltime oncologist and affiliates in larger towns to bring CALGB programs to underserved rural areas of the state. This will allow accrual of minority populations in towns such as Muscatine and the poor in rural areas served by these programs. As the physicians carrying out the care will be University of Iowa faculty, we will be able to provide quality care and data in these areas.
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